It is wrong that Minister Ernst Kuipers has decided to concentrate pediatric heart care in Rotterdam and Groningen. This is the opinion of the hospitals in Leiden, Utrecht and Amsterdam, which were before the court in Utrecht today. The losing hospitals demand that the judge annul the minister’s decision.
Minister Kuipers wants to concentrate pediatric heart surgery in the Erasmus MC in Rotterdam and the UMCG in Groningen. That should improve quality. The two other centers, Leiden/Amsterdam and Utrecht, are in danger of losing the right to carry out these operations. Today’s substantive proceedings concerned the question of whether Kuipers followed the correct procedure in his decision.
For example, the UMC Utrecht states that the minister did not distribute the permits properly because there were never clear criteria. This already started with Minister Hugo de Jonge, who took the first decision at the end of 2021. By the way, Utrecht was still one of the chosen hospitals and Groningen was left out.
According to the UMCU, it was only in that decision that it became clear which criteria applied. When Minister Kuipers then wanted to make a new decision, ‘a surprise criterion’ suddenly came into play: the accessibility and regional distribution of care. What exactly the minister meant by that also changed over time, according to the UMCU.
The UMC in Leiden and Amsterdam also argue that the process was not conducted carefully. The two hospitals have a joint children’s heart center and are losing it. The ‘very severe measure’ to close two heart centers within two years would have insufficient basis, because there is no acute problem at all, they argue.
The three ‘losers’ also point to the collaboration they have started. Utrecht, Leiden and Amsterdam say they show that good heart care can also be shaped in this way, instead of imposed concentration. Minister Kuipers’ lawyers argue that this is a good first step, but they really need to collaborate with Rotterdam and Groningen, which are allowed to keep the children’s heart centers.
According to the minister, there was no ‘surprise criterion’. Groningen was chosen after the House of Representatives insisted on an impact analysis by the Dutch Healthcare Authority (NZa). This would map out the consequences for each hospital if the heart center were to disappear there.
The NZa came to the conclusion for Groningen that the disappearance of the heart center could be risky for the regional accessibility of acute care and therefore for patients in the Northeast Netherlands. Kuipers then decided not to close Groningen but Utrecht.
That is why the UMC Utrecht also went to court. That hospital says that the new plan is bad for the travel time of patients and their parents. Children from Amsterdam, Utrecht, Arnhem or Roermond, for example, would then have to go to Groningen for an operation. But the travel time is actually an argument for the UMCG to keep the center open there: “It makes quite a difference whether you get sick in Leiden or in Oosterhoogebrug.”
Eduard Verhagen of the UMCG said he is confident that the judge will see the importance for Groningen and that the minister’s decision will not be challenged. “I know there are criticisms of the decision-making process, but I don’t know of any decision-making process that is perfect,” he said.
The court will make a written decision on January 11.